There are many things in our lives that can effect the relationship that we have with food. Our culture, our up bringing, food insecurity, trauma, media exposure and our chronic illness. We often don’t think about the ways that chronic illness effects our relationship with food. But it can have significant impact and is worth consideration. But for some reason, this isn’t something that I generally hear being talked about in either the medical community or the chronic illness community. I’m not sure why, but the mental health impact on the way that food can damage our bodies is often over looked. So, I want to take some time to talk about the way that chronic illness can impact our relationship with food.
When you have a chronic illness, food can have a major impact on the way that you feel. Sometimes, that impact can be severe or even life threatening. Food allergies and foods that trigger severe medical symptoms can leave a person with feelings of trauma related to that food. Imagine eating a peanut butter sandwhich and almost dying because you had an anaphylactic response to the peanuts. How would you feel if someone later presented you with a peanut butter snadwhich? It would be completely reasonable and rational to have a fear response or avoidant behaviors towards foods that could cause you harm on this level.
Consider that often times other people prepare your food for you. When you have food allergies and/or foods that trigger medical symptoms, a great deal of trust is required to allow another person to handle your food. Thus, this kind of trauma goes beyond the way that we respond to just foods. How do we navigate common social gatherings when food is often a common part of get togethers and celebrations? Many social events become dangerous and emotionally triggering. Going out to a restraunt that you’ve never been to and haven’t done any research on can become terrifying. A simple date, suddenly becomes something quite complex. This becomes a significant social obstacle in the lives of many people with chronic illness.
It can be difficult to talk about the trauma related to food. For one, it is always difficult to talk about an event that was traumatic. But there is the added difficulty that this is an exerpience that is difficult for many people to understand and thus they can easily down play the severity of the event. Adding further difficulty is that it often requires us to establish a basic understanding of our chronic illness for people to be able to understand why the food event happened, let alone why it was severe and traumatic. That’s a lot of hurdles and takes a lot of spoons. Most of the time, we find it easier to avoid these social situations then to use up our spoons to explain why these kinds of events are difficult for us.
Anxiety around food isn’t that surprising when you consider that food could cause a migraine or an allergic reaction or severe gut pain. All kinds of practical and protective behaviors can develop that can be seen as anxiety even when they aren’t. Sometimes, these behaviors are a combination of being practical/protective and anxiety driven; just to make things more complicated. But checking labels, researching or avoiding restruants, being reluctant or even unwilling to try new foods and not eating food prepared by anyone but a trusted person are all patterns of behaviors that are pretty reasonable, but could also easily get out of control if anxiety begins to drive them.
When you require a narrow range of foods in order to stay healthy and comfortable, it becomes a lot of work just to keep your self fed. What this often means is that food and eating becomes another chore rather than a source of pleasure. Many of us with chronic illness are forced into keeping track of what we are eating and when we are eating. Many of us keep detailed food logs. This is a lot of work. Sometimes, it feels like keeping yourself fed is a full time job all by itself.
When eating becomes a chore, it changes your relationship with your food. There are some benefits to the detailed record keeping. It keeps you honest with yourself and your providers about what your eating habits look like. It gives you a very realistic picture of what your intake really looks like. When people ask me what my food patterns are, I can confidently describe my intake patterns because I have been documenting them in little notebooks for about a decade now. This is a kind of knowing that can only come from really paying attention to your daily habits and the trends that develope over the weeks, months and years.
But it also makes me want to avoid eating. When I am tired or other wise low on spoons, it can be tempting to skip eating so that I can save on all the spoons that goes into it. Because there is nothing spontaneous about eating. When you are on a strict diet, you are likely making most of your meal choices while you are buying your food. You will most likely be cooking most of your food from scratch, because there is no such thing as a pre-boxed “low glycemic index, low histamine, pescatarian, high sodium meal.” You have to make that stuff for yourself. Spoons for meal planning. Spoons for shopping. Spoons for meal prep and cooking. Spoons for the actual eating of the meal. Spoons for documenting. A lot of spoons go into eating. And some days, there just aren’t enough spoons for all the things life demands that you accomplish. It can be all too easy to dismiss the importance of eating as a way to save spoons and avoid a series of chores.
Food Adversions and Social Stigmas
When you start avoiding foods, it is often misunderstood by those observing your behaviors without context. Often times, people begin to assume that you have an eating disorder when they never see you eating at any of the social gatherings or when you are eating only a narrow selection of items. This means that we often get labeled as having mental health problems and get hit with all the stigma that goes along with that. Whether you have an eating disorder or are mistaken as having one doesn’t matter, the problems that result are the same. It’s unfortunate that mental health comes with so much stigma, but it is a reality that we must both face and discuss if we have any hope of ever making any real changes.
This stigma is doubly dangerous. The first layer of stigma comes from the social interactions that we have. Once people have labeled us as having mental illness, they often also label us as being “broken” or “weak” individuals that are choosing this life style. This isn’t true, regardless of whether or not someone is diagnosed with an eating disorder. No one chooses to have a life full of struggles and suffering. Once people believe that we are choosing this, they also believe that we can easily choose to live another way. That’s where statements like “snap out of it” and “if you’d just wake up” come from. There is this idea, that we can just decide to not have these problems anymore. When people believe this, they are less likely to be supportive of the person suffering.
There other layer of stigma is through the medical system. Once you have been labeled as having any kind of mental health on your medical file there is a shadow cast over all of your medical conditions. Somehow, having a mental health diagnosis invalidates every other diagnosis on your chart. It then becomes the patient’s responsibility to prove that their medical problems are real and they are not somatic delusions evented by their mental illness. It doesn’t matter if their mental health diagnosis is one that included psychosis or not. This stigma casts that shadow regardless of how much sense it actually makes when clinically examined.
Luckily, not everyone we encounter will buy into the stigma narrative and many will help us fight back against it. But it is an important part of the way that we interact with food. Once we have a history of being labeled as somatic, we are at risk for questioning our own realities. This can put us in the risky position of challenging our past experiences by trying to force ourselves to eat in socially normal ways. Social pressure can have a lot of power. Everyone wants to belong and feel loved. If our family and friends are constantly telling us that these things are in our heads, it is easy to begin having a confrontional relationship with food all in hopes of being accepted into the social group.
A Positive Note
Having chronic illness can also have some good infleunce on our relationship with food. It can lead us to considering our diets in ways that we never had before. It often leads to us eating much healthier foods. There becomes an inevitable focus on our eating that can often cause a positive shift towards mindfully eating. When we begin making our health a priority in our lives, as we are often forced to do when diagnosed with chronic illness, we often assess the way that we are eating as part of that process. When we work towards a diet that better aligns with our biological needs, we are on a path towards greater health. So, yes, having chronic illness can help us have a better relationship with our food too.